Clinical and neurological features of different variants of peripheral polyneuropathy in patients with type 2 diabetes mellitus

The aim: to determine the clinical and neurological features of polyneuropathies depending on the pathomorphological type of peripheral nerve damage in patients with type 2 diabetes mellitus (DM). Materials and methods: We examined 96 patients who were being treated in the endocrinology department of the University Hospital of KhNMU, with a diagnosis of type 2 DM and a complication - peripheral polyneuropathy (PNP). All patients completed a general clinical and neurological examination, assessment of the severity of polyneuropathic syndrome using specialized scales, and electroneuromyographic examination to assess the morpho-functional type of peripheral nerve damage. Results: All patients were divided into three groups according to the results of electroneuromyographic examination: group 1 - axonal type (n = 37); group 2 - demyelinating type (n = 29); group 3 - mixed (axonal-demyelinating) type (n = 30). Further, during the study, depending on the morphofunctional type of peripheral nerve damage, the clinical and neurological status of patients and the results of valid scales (TSS, NIS LL, MNSI, The pain DETECT questionnaire, the VAS analogue scale) were analyzed. The symmetry of neurological symptoms and clinical and neurological status disorders in patients with different types of peripheral neuropathy were also investigated. Conclusions: The study showed that patients with axonal PNP in type 2 DM are more characterized by subjective neurological symptoms and reduced reflexes. In patients with a demyelinating type of PNP, impaired vibration sensitivity, decreased muscle strength in the extremities, and increased tendon reflexes of the lower extremities predominate. Patients with mixed types of PNP complain more of symptoms characteristic of axonal damage, and impaired vibration sensitivity and decreased muscle strength are also observed